Billing code 44394: Stomal colonoscopyMedicare rate & RVUs in Virginia
Report this service when a colonoscope is passed through a stoma and a colonic lesion is removed using a snare during the examination.
Medicare pays $472.94–$552.35 for 44394 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 44394 covers
A gastroenterologist or colorectal surgeon advances a colonoscope through a colonic stoma to examine the colon and remove a tumor, polyp, or other lesion with a snare. This may occur during an outpatient endoscopy or a hospital-based procedure for a patient with a colostomy. The approach through the stoma and the snare removal distinguish this service from routine inspection, forceps removal, and colonoscopy performed through the anus.
Select the code from the access route and documented removal technique; the report should identify the stoma approach and the lesion treatment performed. This minor procedure has a 0-day global period, so same-day preoperative and postoperative care is included. When related endoscopies are performed together, CMS endoscopy family pricing applies. Modifier 50 is inappropriate because the descriptor and anatomy do not support bilateral adjustment. CMS does not pay an assistant at surgery for this service; co-surgeons and team surgery are not permitted.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 44394 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $552.35 | $217.91 |
| Virginia | $472.94 | $193.85 |
How the 44394 rate is calculated
Each of 44394’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 44394
RVUs × geographic indexes × conversion factor
Work3.93
3.93 RVUs× 1.000 GPCI
Practice expense10.04
10.04 RVUs× 1.000 GPCI
Malpractice0.51
0.51 RVUs× 1.000 GPCI
Adjusted RVUs
14.4800
Conversion factor
$33.4009
Medicare rate
$483.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 44394
The CMS indicators that decide how 44394 is paid alongside other services.
CMS payment indicators · 44394
Stomal colonoscopy
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 3 | Endoscopy family rules apply. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 1 | Not paid (statutory restriction). |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
44394 without 51 · national office
$483.65
Stomal colonoscopy
44394-51 · Second procedure: 50%
$241.83
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
44394 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 44392Stoma colonoscopy
- Both involve lesion removal through a stoma, but 44394 is selected for snare technique; 44392 describes hot biopsy forceps or bipolar cautery.
- 44389Colonoscopy
- 44389 is for biopsy sampling through the stoma. Choose 44394 when the lesion is removed with a snare.
- 45385Snare polypectomy
- The snare removal technique is similar, but 45385 is for colonoscopy through the anus; 44394 is for access through a stoma.
44394 billing questions
How does this differ from 44392?
Both describe lesion removal during colonoscopy through a stoma. Use 44394 for snare removal; 44392 is for removal by hot biopsy forceps or bipolar cautery.
When is 44389 more appropriate?
Use 44389 when tissue is sampled by biopsy during colonoscopy through a stoma rather than removed by snare.
Can the diagnostic examination be billed separately?
The code describes snare removal during the examination, not a separate diagnostic-only procedure. When related endoscopies are performed together, CMS endoscopy family pricing applies.
Should modifier 50 be reported?
No. The descriptor and anatomy make bilateral adjustment and modifier 50 inappropriate.
Can an assistant or co-surgeon be paid?
CMS does not pay an assistant at surgery for this service. Co-surgeons and team surgery are not permitted.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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